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50 Valium Since June Is Not a Lot of Drug
Headlines abound about the psych pills taken by the Las Vegas killer. Fifty Diazepam, aka Valium, at the highest end strength of 10 mg was picked up by Mr. Evil in June. Unless further evidence comes out that there weren’t refills, but that’s a big unknown.
Diazepam is an older person’s request. Younger people ask for Xanax. In older times I might write for bigger numbers and higher doses but I’m far, far more cautious in my old age, using lower doses and fewer pills. There’s a war on pills, and with good reason; they cause bad problems.
Diazepam has a long half-life and plenty of drug interactions. Mixing it with other central nervous system acting substances can produce problems, like lack of breathing. It is a benzodiazepine used commonly for anxiety, often with 2-5 mg doing the trick. Sometimes I use it for insomnia but there’s better meds in its class and even better outside its class. I use it for veritigo and sometimes muscle spasms.
I have plenty of experience with this drug, even taking it preoperatively twice for eye surgeries. No wonder I don’t perform eye surgeries anymore. (OK, it was for LASIK I had done. It was a mellow jello sort of feeling.)
Once there was a drug addict paramedic who had a cocaine OD and kept calling me Doogie. I hit him with IV diazepam in 10 mg increments, ending up with nearly 400 mg, because I just kept dosing this obnoxious jerk every time he called me Doogie. I did have the luxury of an ICU setting.
I remember someone getting diazepam in the hospital when I was an intern, and having a paradoxical reaction of increased agitation. We gave her more diazepam and she got worse. An older attending doc figured it out fast. Don’t ever knock experience.
I’ve seen gambling addicts, often doing cocaine, get diazepam from casino sources. Pills are harder to get these days but not that hard. Higher money players can often find someone willing to make a buck.
Heavy use of diazepam would be 30 mg a day or more but a psychological dependency could exist at 5-10 mg a day. Yes, I’ve seen this drug, combined with multiple other medications, cause death.
So Mr. Evil got 50 pills in June. Not so uncommon for a 60-something gambling addict. Speaking of which, an addict with bad losses would not do something like this horror over losses if he had money left. Where there’s money, there’s hope in that twisted world. Pro gamblers are usually jerks, annoying to interact with.
It would be extraordinary rare for this drug to change the man. It’s possible its use made horrible ideas seem OK to him. Lots of psych meds can make the abhorrent somehow tolerable. It is almost certain he had experience with this medication prior to this.
Like many I’m interested to find out if this guy was bat-guano crazy or had a motive and performed evil in some greater name. We shall find out soon, I expect. The worst I see the drug doing in this case is lessening whatever internal revulsion he had regarding his thoughts. I’m not sure this man had a conscience though, damn him.
Published in General
I think you cannot overstate this point.
What’s hard about this is that the heroes also see those movies and tv shows. So the explanation still must be sought: why do some men (esp. men) do noble and wonderful things with their energy while others do absolutely horrifying things?
My son sent me a photo of an American soldier on leave serving as a human shield for a woman; he went back and did first aid and evacuation afterward.
Where do we get these people? How could we possibly deserve them?
Hey! What happens in Venice stays in Venice, I was told.
What does anyone think of the idea it’s unlikely he could have set all this up, taken the windows out, and done all the shooting alone?
That could have been Lt. Col. (Ret.) Dave Grossman who has written about it in several places, including Assassination Generation: Video Games, Aggression, and the Psychology of Killing.
He is supposed to be an intelligent guy. Never underestimate the resourcefulness a man may bring to evil. That’s not to say he definitely had no help, but I know I would not need any.
It takes brains and stealth for such prep. That’s it. It doesn’t seem hard to me at all.
The act of course takes pure evil, something that everyone but my ex wife knows I lack.
Alex Jones’ theory: he was a gun runner, his girlfriend recruited buyers
from all over the world, and staff at the Mandalay Bay Hotel had been
co-conspirators who had been taking a cut of his profits. This would
explain why he was able to have 23 g*ns and thousands of ammo rounds in
a hotel room without drawing any attention from the maids. This is Las
Vegas, after all. High stakes gambling is pretty much the only legal
way to launder huge sums of money – get $250K of chips, gamble for a
while, then cash out and get $150K of different cash. Hotel gets paid,
P@ddock gets clean cash, gun sale completed, Marilou leaves to find the
next buyers, everyone’s happy.
Might be a bridge too far.
why did you not spell out “guns”? @trink
What, and then he freaked out and decided to use the guns to kill a bunch of people? That seems…baroque. Who knows: we might all be about to get an education in the strange world of Las Vegas?
That’s actually helpful, Arahant. So if he was planning and doing all of this on his own, why all the extra guns? You don’t need ten guns (clearly) you just need one gun (or maybe two, in case one jams or malfunctions) and a lot of ammo. No?
I could posit several reasons:
That is four off-the-cuff.
Really good ones, too!
By the way, this makes me sad: “Rep. Tim Murphy announced yesterday that he is stepping down from office, after the Pittsburgh Post-Gazette revealed earlier this week that the GOP lawmaker had encouraged his girlfriend to get an abortion.”
Murphy was a big advocate for reforming our “system” for caring for the severely mentally ill.
Sigh.
He’s also bat-guano nuts.
But there was method to his madness.
You could argue that anyone who would even consider such a heinous act is, by definition, crazy. However, he acted completely rationally while he methodically and carefully set all this up. Not many crazy people can do that, especially those with the DSM-5 diagnosis of BGC (Bat Guano Crazy). The inability to understand such horrible things is one reason that many of us believe in the existence of something called “evil.” Many people really don’t believe in evil (…surely if we just sat down with Kim Jong Un we could just work all this out…), but I believe it exists. I don’t understand it, but I acknowledge its existence.
Anyway, I agree with DocJay in that I am unimpressed by finding some Valium in his medicine cabinet. What percentage of the medicine cabinets in Las Vegas contain Valium or one of it’s cousins? I would guess two thirds, maybe? Big deal. How much Valium did he actually take? I would argue, “Not nearly enough.”
The increasing frequency of mass shootings is, in my opinion, very concerning. Whatever pathology leads someone to commit such uncommonly horrible acts seems to be becoming, well, less uncommon. Is it the movies and video games referenced above? Is it the changes in the way we raise boys and treat men? Is it the increasing tribalism and isolation in our society? Is it the loss of the traditional structures of society, like family, church, etc? Is it something else?
Hard to say, but I would suggest that we need to figure that out pronto. But I doubt that we will.
As cold as this sounds, the biggest problem is really not the loss of varying numbers of innocents to senseless violence. The real problem is the changes these events lead to in our interactions with each other. The idea of security at a music concert seems silly to me, but just wait – soon we’ll have airport style security at grocery stores. And our increased obsession with security will lead to a citizenry begging for protection, and thus a citizenry who more willingly tolerates increasingly intrusive and dominating government. And that road leads nowhere good.
This is why I doubt that we’ll solve this problem. The powers that be really don’t want it solved. It leads to more power for them.
You can’t make an omelet without breaking a few eggs…
Or he accumulated these over a two-week period and kept changing his mind about which ones he wanted to use.
Oh—were they all different kinds of guns? For some reason I thought they were all more or less the same.
This is where we go wrong on mental illness: severely mentally ill people can be unbelievably delusional.
A delusion is different from a hallucination. Delusions alter the order of thoughts in the rational mind and make mistakes in drawing inferences with respect to real events. Hallucinations are more like dreams that the person thinks are reality.
Therefore, a seriously delusional mentally person can appear to be as sane as you or I.
We–including some psychologist and psychiatrists I’ve known–make a big mistake in assessing delusional thinking using simply interviews with patients. Delusional patients are quite capable of putting subjects and verbs in the right order. Self-care can be very good. And the basic cognitive skills we look for are all operating perfectly.
There’s only way to find it, and that is to know the facts of a situation, such as a family history. Otherwise, if you don’t know who or what the person is talking about, you will not know that everything the person is saying about those people or incidents is totally screwed up.
We all think we can assess a person’s sanity in a five-minute conversation. But we can’t. We have to know the facts of the situation in order to compare the facts against the patient’s interpretation of those events.
You probably should not use this wording until you meet me…
All of the above?
I come back again to the quality that exists in human beings, especially men, that allows us to kill and die for an idea. Sometimes the cause is no more noble than “he dissed me” — especially prevalent in honor cultures where the state is too weak to provide protection, so a reputation for “don’t mess with me” is a proactive defense. This, combined with the usual sexual jealousies, is a common motive for violence in inner city communities.
But terrorists are driven by fidelity to a cause, often—though not always—with actual or perceived leaders giving direction and providing the theory for the gunman’s (or bomber’s) practice. I believe, for example, that Micah Johnson murdered five Dallas police officers because he believed the #BLM idea that racist police officers are deliberately targeting black people for murder. The fact that President Obama, the alpha male of the planet, had just essentially confirmed this view in his statements to the press after the deaths of Castile and Sterling, may not have been coincidental (Full disclosure: I am convinced that it wasn’t coincidental, and I am angry.)
A mentally ill person in the grip of a psychosis (that is, whose mind has been disconnected from reality) may perceive his victim as an enemy —Satan, let’s say, who has taken up residence in Grampa’s body. He may have a voice—often male, interestingly—in his head urging him to kill Satan.
He can be truly psychotic and delusional, and still have the mental wherewithal to, for example, drive a car or plan a murder, or hide from the police, but it is easier to recognize their decline into madness, if only retroactively, once you know what you’re looking at. (It’s called “decompensating” and it is not pretty.) Unfortunately, even if you see it happening, there is often not much you can do. Up to a certain point, the person has to consent to treatment. Would you take pills or a ride to the E.R. from Satan?
But a person driven by an idea or a cause can be completely sane. He is (or sees himself as) a warrior. Indeed, if he is willing to die and kill for a cause that you and I recognize as just, we call him a hero.
It’s hard to know, at this point, which Paddock might have been.
He could have been BSC. He could have been a sane (ish) guy who believed himself to be a warrior fighting Jihad or fighting Trump or fighting Corporate America, whatever, and still behave as his girlfriend described: lying in bed, weeping and crying “Oh God!” for example, as he ginned himself up for his big moment. And of course, sending her away and then sending her money are pretty classic “just before the battle, mother” moves.
Either way—nuts or jihadi—there may be lessons to be learned from the Las Vegas atrocity, hopefully ones that bear on how to prevent similar future atrocities. But the details matter, and we don’t have them yet.
Yeah, sounds like one of my first cousins. Successful nurse. Takes care of herself and her family just fine. But mention the name Reagan, and you never know what will come out of her mouth and what she’ll blame him for. Once, she blamed Reagan for sending her husband to Vietnam. The husband was not a Californian. He was from Texas. Let that sink in.
Yep.
Paddock was insane by the simple definition that he was a danger to himself and others.
He was clearly rational in that he could organize and complete tasks and interact rationally with others around him.
A rich delusional guy would be hard for anyone to identify as delusional.
That’s the Cleaning Woman Syndrome:
Back to the soldier who gives his life for others: That is rational even though he is “a danger to himself” by doing it. The soldier is gaining something for himself, which is saving someone else, a person he wants to have life (wiping tear away).
As others have said, I think we have to look at the purpose of the “danger to himself or others” to complete the sanity equation.
This is true.
I do believe that evil stalks the earth in some way. Osama bin Laden was a rich evil being. I’m less clear as to whether his minions were evil.
It is really hard to pick out the bin Ladens because they have the money and other resources to hide and disguise their evil and sociopathic mind.
Ah! The person who sent me this is a bit paranoid about the attention of the take-your-guns guv’mnt being triggered by using the word.